School refusal refers to a pattern where a child experiences significant difficulty attending school due to emotional distress. Unlike truancy, which typically involves deliberate absence without permission, school refusal is often linked to anxiety, trauma, bullying, or other conditions that make the school environment feel overwhelming or unsafe. Children experiencing school refusal may express intense fear, physical symptoms such as stomach aches, or strong resistance to attending school. Understanding school refusal requires recognising that the behaviour often reflects underlying distress rather than defiance. Effective responses often involve addressing the factors contributing to the child’s anxiety and creating supportive pathways back to participation in education.